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Hospital Ends Liver Program

St. Vincent had skipped patients on a waiting list. Transplants of other organs will continue.

November 04, 2005|Charles Ornstein | Times Staff Writer

St. Vincent Medical Center will announce today that it is closing its liver transplant program, weeks after the Los Angeles hospital acknowledged that its doctors misappropriated an organ in a serious violation of national standards.

"It's the right thing to do for this organization," St. Vincent President and Chief Executive Gus Valdespino said.

Valdespino suspended the program in late September after discovering the inappropriate transplant, which occurred in 2003. He admitted that doctors had transplanted a donated liver into a Saudi national who ranked 52nd on the regional waiting list, bypassing dozens of people whose conditions were considered more dire, and that hospital staff members subsequently falsified documents to cover up the action.

A St. Vincent patient who was at the top of the list for a liver -- but did not receive one -- subsequently died.

This week, Valdespino said the hospital decided to close the transplant program permanently because of ongoing investigations, the competitive environment and the challenges of rebuilding.

"The resources, the energy, the attention that would need to be devoted to restoring the program, we thought it would be detrimental and would take us away from continuing to focus on the core programs here," he said.

St. Vincent's has one of the largest overall transplant programs in the state. It will continue to transplant kidneys, pancreases and hearts. The hospital has not found any problems with these programs, Valdespino said.

The liver program, which began in 1995, was relatively small. Nineteen cadaver organs were transplanted last year and 16 this year before it was suspended.

The decision means the 75 patients who were on St. Vincent's waiting list for a liver transplant must be moved to lists maintained by other hospitals in the region. About a third have already been moved. It is unclear how the transition will affect their chances of ultimately receiving new livers.

For the next three months, the hospital will continue to provide care to the 170 patients who received transplants at the hospital in the last decade. Valdespino said officials are still working out how these patients will be treated and tracked in the long term.

The 14 employees working for the liver program will be offered either jobs elsewhere in the hospital or help in seeking another job, he said.

When the program was suspended, St. Vincent terminated its contracts with the two surgeons who led the program. A lawyer for former director Dr. Richard R. Lopez Jr. has declined to comment. An attorney for Dr. Hector Ramos, the former assistant director, has said her client did nothing wrong.

The liver program was closed under pressure from the federal government, which withdrew the unit's certification Sept. 30. Without that approval, the hospital was no longer eligible to receive Medicare and Medicaid reimbursements for liver transplants -- a potentially crippling blow.

"There is no provision that would allow a transplant facility to inactivate its program and then reactivate it once any deficiencies have been corrected," Medicare official Laurence D. Wilson wrote in a letter to Valdespino.

Valdespino said this week that the hospital was still investigating the liver transplant program and had not found other evidence of wrongdoing. Two employees have been suspended for helping to cover up the improper transplant.

Investigations also are underway by the state Department of Health Services, the federal Medicare agency and the group charged with administering the national organ transplant system.

The United Network for Organ Sharing plans an audit of all transplants performed at St. Vincent in the last five years, Valdespino told a confidential meeting of the medical staff last month.

St. Vincent liver patients can get more information by calling (866) 478-8462.

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